The costs and effectiveness of critical care units have been more debated than researched. The proposed research seeks to examine the degree to which essential elements of care for burned patients are present in various hospital settings and to determine how differences in these elements of care and organizational structures relate to increased patient survival and to cost. This pilot study will examine care given in 10 hospitals with institutional facilities ranging from those with major burn treatment centers to those with no special facilities for care of burned patients. Criteria for the optimal care of burned patients will be developed. The following measures will then be developed and used to collect data from the respective sources: 1) patient prognostic variables to adjust for outcome differences between hospitals due to differences in patient mixes, 700 patients; 2) a case abstract for patient records to ascertain retrospectively the quality of professional (medical and nursing) performance, 700 patients; 3) an observational form to ascertain concurrently the quality of nursing performance, 120 patients; 4) a test of knowledge of nursing care for burns, 200 staff nurses; 5) a survey of staff views concerning organizational functioning, 300 staff members; 6) an administrative questionnaire detailing the administrative organization of the care unit, 10 hospitals; 7) a checklist concerning the physical design of the unit, 10 hospitals, and 8) a uniform assessment of capital and labor costs for the care of burned patients in the unit, 10 hospitals. The pilot study will determine the methodological adequacy of the measures which have been developed and perform initial tests of hypotheses concerning relationships between patient survival, professional performance, resource utilization, and costs. The results should be useful to administrators, practitioners, educators, and policy makers for improving the effectiveness and efficiency of care for burned patients.